Provider Demographics
NPI:1841530375
Name:TRILLIUM HEALTH RESOURCES
Entity type:Organization
Organization Name:TRILLIUM HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:B
Authorized Official - Last Name:FUTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-332-4137
Mailing Address - Street 1:144 COMMUNITY COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-8047
Mailing Address - Country:US
Mailing Address - Phone:866-998-2597
Mailing Address - Fax:
Practice Address - Street 1:144 COMMUNITY COLLEGE RD
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-8047
Practice Address - Country:US
Practice Address - Phone:252-332-4137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6703002Medicaid